<span style="font-family:Verdana;">In our study, we aimed to optimize the dosage regimen of Isavuconazole </span><span style="font-family:""><span style="font-family:...<span style="font-family:Verdana;">In our study, we aimed to optimize the dosage regimen of Isavuconazole </span><span style="font-family:""><span style="font-family:Verdana;">against </span><i><span style="font-family:Verdana;">Candida spp. </span></i><span style="font-family:Verdana;">and </span><i><span style="font-family:Verdana;">Aspergillus spp. </span></i><span style="font-family:Verdana;">by Mo</span></span><span style="font-family:Verdana;">n</span><span style="font-family:Verdana;">te Carlo simulation (MSC). Pharmacokinetic parameters and microbiological data of Isavuconazole were collected. Then we used MSC to simulate 10,000 patients analyzed by Crystal Ball to calculate probability of target attainment (PTA) and cumulative fraction of response (CFR). With dosages of 100</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, 200</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, and 400</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg in oral group and dosages of 100</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, and 200</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg in intravenous administration, all have different degree</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> of antifungal effect. But when the dosage regimen was 50</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">mg IV, the therapeutic effect of Isavuconazole against </span><i><span style="font-family:Verdana;">Aspergillus spp.</span></i><span style="font-family:Verdana;"> and </span><i><span style="font-family:Verdana;">Candida spp. </span></i><span style="font-family:Verdana;">were not good.展开更多
Invasive fungal infections (IFI) have recently become increasingly more prevalent, resulting in an increased risk of morbidity and mortality. Both Candida spp. and Aspergillus spp. are major causes of IFI. In this stu...Invasive fungal infections (IFI) have recently become increasingly more prevalent, resulting in an increased risk of morbidity and mortality. Both Candida spp. and Aspergillus spp. are major causes of IFI. In this study, we aimed to evaluate the cumulative fraction of response of various dosage regimens of posaconazole against nine Candida spp. and six Aspergillus spp. in both children and adults. Monte Carlo simulation (MCS) was performed to optimize selection of posaconazole dosage regimens. For children, a dosage regimen of 120 mg/m2 posaconazole tid was sufficient to treat fungal infections caused by all six Aspergillus spp. and six of the nine Candida spp. (but was not effective against C. glabrata, C. guilliermondii and C. krusei). In contrast, a 400 mg dosage regimen of posaconazole bid achieved the target pharmacokinetic/pharmacodynamics (PK/PD) parameters against all six Aspergillus spp. and eight of the nine Candida spp. (but was not effective against C. glabrata) in the adults. Dosage regimens of 50 mg bid, 100 mg bid, or 200 mg bid were not effective. Posaconazole dosage regimens are likely to achieve their desired PK/PD targets against Candida spp. and Aspergillus spp. in both children and adults.展开更多
The incidence of yeast infections has increased significantly over the past few years, constituting a leading cause of morbidity and mortality among hospitalised patients. The rapid identification of candidiasis is im...The incidence of yeast infections has increased significantly over the past few years, constituting a leading cause of morbidity and mortality among hospitalised patients. The rapid identification of candidiasis is important for the clinical management of patients and to facilitate tracing the sources of infections in hospitalized patients. Here, we report a retrospective, single-centre study of Candida spp. distribution and antifungal susceptibility from January 2011 to May 2013 at a hospital in México City, regarding the importance of elucidating the identity of the infection-causing Candida species in order to improve prophylactic measures and treatment. Clinical data were collected from patient medical records and the laboratory database. Isolates were initially identified using standard mycology techniques, and then confirmed by PCR-based system using amplification of intergenic spacers (rDNA ITS) and restriction length polymorphism of PCR products after sequence-specific enzymatic cleavage (PCR-RFLP). We observed no shift from C. albicans to non-albicans Candida species: Candida albicans (73.7%) was the most prevalent species isolated, while C. dubliniensis was not identified in this study. Antifungal susceptibility was determined using FUNGITEST<sup>®</sup>;17.4% of C. albicans isolates were resistant to fluconazole and 21.7% to itraconazole. Multiplex PCR microsatellite analysis of the clinical C. albicans isolates using primers for the CAI, CAIII and CAVI loci identified 29 different alleles for CAI, 8 alleles for CAIII and 31 for CAVI. The combined discriminatory power of these three microsatellites was 0.98, which was considered reliable for molecular typing. Genetic analysis of these isolates revealed a clonal population with a total of 62 genotypes from the examined isolates展开更多
目的了解新型抗真菌药物米卡芬净(micafungin,MFG)对分离自中国的念珠菌和曲霉临床株的体外抑菌活性。方法参照CLSI(Clinical and Laboratory Standards Institute,以前为NCCLS)制定的M27-A2和M38-A方案测定86株念珠菌和35株曲霉的最低...目的了解新型抗真菌药物米卡芬净(micafungin,MFG)对分离自中国的念珠菌和曲霉临床株的体外抑菌活性。方法参照CLSI(Clinical and Laboratory Standards Institute,以前为NCCLS)制定的M27-A2和M38-A方案测定86株念珠菌和35株曲霉的最低抑菌浓度(MIC)或最低有效浓度(MEC)。结果MFG对大多数念珠菌属和曲霉属均有较好的抑菌作用。对念珠菌属的MIC90从高到低依次为:氟康唑(FLC)敏感的白念珠菌、热带念珠菌、光滑念珠菌为0.125μg/ml,FLC耐药和剂量依赖敏感株为0.25μg/ml,克柔念珠菌为0.5μg/ml,近平滑念珠菌8μg/ml,季也蒙念珠菌>16μg/ml。MFG对烟曲霉的MEC90为≤0.03μg/ml,对非烟曲霉的曲霉属MEC90为0.06μg/ml。MFG与唑类药物、两性霉素B(AMB)不存在交叉耐药,对FLC耐药的念珠菌、伊曲康唑耐药的曲霉、AMB不敏感的曲霉均有好的抑菌活性。结论MFG对多数念珠菌属和曲霉属(包括对唑类耐药和AMB不敏感的菌株)有较好的体外抑菌作用。展开更多
文摘<span style="font-family:Verdana;">In our study, we aimed to optimize the dosage regimen of Isavuconazole </span><span style="font-family:""><span style="font-family:Verdana;">against </span><i><span style="font-family:Verdana;">Candida spp. </span></i><span style="font-family:Verdana;">and </span><i><span style="font-family:Verdana;">Aspergillus spp. </span></i><span style="font-family:Verdana;">by Mo</span></span><span style="font-family:Verdana;">n</span><span style="font-family:Verdana;">te Carlo simulation (MSC). Pharmacokinetic parameters and microbiological data of Isavuconazole were collected. Then we used MSC to simulate 10,000 patients analyzed by Crystal Ball to calculate probability of target attainment (PTA) and cumulative fraction of response (CFR). With dosages of 100</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, 200</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, and 400</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg in oral group and dosages of 100</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg, and 200</span><span style="font-family:""> </span><span style="font-family:Verdana;">mg in intravenous administration, all have different degree</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> of antifungal effect. But when the dosage regimen was 50</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">mg IV, the therapeutic effect of Isavuconazole against </span><i><span style="font-family:Verdana;">Aspergillus spp.</span></i><span style="font-family:Verdana;"> and </span><i><span style="font-family:Verdana;">Candida spp. </span></i><span style="font-family:Verdana;">were not good.
文摘Invasive fungal infections (IFI) have recently become increasingly more prevalent, resulting in an increased risk of morbidity and mortality. Both Candida spp. and Aspergillus spp. are major causes of IFI. In this study, we aimed to evaluate the cumulative fraction of response of various dosage regimens of posaconazole against nine Candida spp. and six Aspergillus spp. in both children and adults. Monte Carlo simulation (MCS) was performed to optimize selection of posaconazole dosage regimens. For children, a dosage regimen of 120 mg/m2 posaconazole tid was sufficient to treat fungal infections caused by all six Aspergillus spp. and six of the nine Candida spp. (but was not effective against C. glabrata, C. guilliermondii and C. krusei). In contrast, a 400 mg dosage regimen of posaconazole bid achieved the target pharmacokinetic/pharmacodynamics (PK/PD) parameters against all six Aspergillus spp. and eight of the nine Candida spp. (but was not effective against C. glabrata) in the adults. Dosage regimens of 50 mg bid, 100 mg bid, or 200 mg bid were not effective. Posaconazole dosage regimens are likely to achieve their desired PK/PD targets against Candida spp. and Aspergillus spp. in both children and adults.
文摘The incidence of yeast infections has increased significantly over the past few years, constituting a leading cause of morbidity and mortality among hospitalised patients. The rapid identification of candidiasis is important for the clinical management of patients and to facilitate tracing the sources of infections in hospitalized patients. Here, we report a retrospective, single-centre study of Candida spp. distribution and antifungal susceptibility from January 2011 to May 2013 at a hospital in México City, regarding the importance of elucidating the identity of the infection-causing Candida species in order to improve prophylactic measures and treatment. Clinical data were collected from patient medical records and the laboratory database. Isolates were initially identified using standard mycology techniques, and then confirmed by PCR-based system using amplification of intergenic spacers (rDNA ITS) and restriction length polymorphism of PCR products after sequence-specific enzymatic cleavage (PCR-RFLP). We observed no shift from C. albicans to non-albicans Candida species: Candida albicans (73.7%) was the most prevalent species isolated, while C. dubliniensis was not identified in this study. Antifungal susceptibility was determined using FUNGITEST<sup>®</sup>;17.4% of C. albicans isolates were resistant to fluconazole and 21.7% to itraconazole. Multiplex PCR microsatellite analysis of the clinical C. albicans isolates using primers for the CAI, CAIII and CAVI loci identified 29 different alleles for CAI, 8 alleles for CAIII and 31 for CAVI. The combined discriminatory power of these three microsatellites was 0.98, which was considered reliable for molecular typing. Genetic analysis of these isolates revealed a clonal population with a total of 62 genotypes from the examined isolates
文摘目的了解新型抗真菌药物米卡芬净(micafungin,MFG)对分离自中国的念珠菌和曲霉临床株的体外抑菌活性。方法参照CLSI(Clinical and Laboratory Standards Institute,以前为NCCLS)制定的M27-A2和M38-A方案测定86株念珠菌和35株曲霉的最低抑菌浓度(MIC)或最低有效浓度(MEC)。结果MFG对大多数念珠菌属和曲霉属均有较好的抑菌作用。对念珠菌属的MIC90从高到低依次为:氟康唑(FLC)敏感的白念珠菌、热带念珠菌、光滑念珠菌为0.125μg/ml,FLC耐药和剂量依赖敏感株为0.25μg/ml,克柔念珠菌为0.5μg/ml,近平滑念珠菌8μg/ml,季也蒙念珠菌>16μg/ml。MFG对烟曲霉的MEC90为≤0.03μg/ml,对非烟曲霉的曲霉属MEC90为0.06μg/ml。MFG与唑类药物、两性霉素B(AMB)不存在交叉耐药,对FLC耐药的念珠菌、伊曲康唑耐药的曲霉、AMB不敏感的曲霉均有好的抑菌活性。结论MFG对多数念珠菌属和曲霉属(包括对唑类耐药和AMB不敏感的菌株)有较好的体外抑菌作用。
